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Synthesizing the frameworks described above allows us to identify the structural capacity needs of organizations or agencies, coalitions, or other collaborative entities that are undertaking community engagement. Synthesis starts with the four practice elements of constituency development developed by Hatcher et al. (2008). Appendix 4.1 contains a table for each of the four practice elements (know the community, establish strategies, build networks, and mobilize communities) that sets forth its components in detail. The text here touches only on their major points.

Practice Element 1: Know the Community

The first practice element is focused on knowing the community’s history and experience, its constituents, and their capabilities. In a sense, this practice element addresses the intelligence-gathering function behind planning, decision making, and leveraging resources to collaboratively achieve anticipated or agreed-upon outcomes with community partners. As depicted in Table 4.1, this element speaks to the need for a wide range of data types, secure reporting and collection systems, human skills and equipment to analyze and interpret data, organizational processes to communicate this information and foster its use in decision making, and a culture that values community-engaged information gathering and use. The goal is to enable all partners to understand diverse viewpoints on community issues and to appreciate the range of solutions that may address those issues.

The individuals and groups from communities or organizations undertaking engagement activities have differing abilities to assimilate data through their respective filters. If understanding is not developed collectively, it is often difficult to move to a collective decision or action. All but the smallest homogenous communities have multiple layers of complexity that require organized, collective ways to obtain and understand community information. In brief, understanding is rooted in experience, social and cultural perspectives, perceptions of influence, and the ability to act collaboratively within the engaging organization and the engaged community. Thus, the task of knowing a community must be approached as an organizational function and supported with sufficient capacity to collectively undertake this work.

Practice Element 2: Establish Positions and Strategies

To successfully address Practice Element 2, structural capacity must be in place to identify the engaging organization’s priorities regarding community health issues as well as any limitations in the organization’s mission, funding, or politics that will restrain its ability to address those issues. The development of positions and strategies allows an organization to effectively plan its role in the community engagement process. In particular, it is critical to be clear about the organization’s intentions and its ability to adjust and align its position to differing viewpoints and priorities likely to exist within the community. An introspective review will examine whether the organization is willing to adjust its priorities in response to the concerns of the community (i.e., takes an open position) or whether it insists on following its own internal priorities (a closed position). The answer to this question should drive the engagement strategy, and the organization must clearly communicate the degree to which it is open to change so that the community can have clear expectations about what can be collaboratively addressed.

Structural capacity is also needed to support the examination of external forces. The understanding of these forces, like the understanding of internal forces, is critical for establishing positions and strategies that facilitate social mobilization and participatory decision making. Another term for the examination of external forces would be “external planning.” In particular, it is necessary to determine whether the community is capable of participating and whether it is ready to take action. If the community lacks capacity, it will be necessary to facilitate the development of its capacity. If the community has capacity but is not ready to act, strategies will need to be developed to help the community better understand the issues and create opportunities for it to act.

When establishing positions through internal and external planning, engagement leaders must consider multiple variables that influence health, including social, cultural, epidemiologic, behavioral, environmental, political, and other factors. An assessment of these factors will provide insight not only into possible targets for health actions but also into competing interests of the community and its potential responses to the organization’s positions and strategies. Organizational positions should be developed through robust analyses and present the organization’s views on the health issue, the range of possible solutions to that issue, and the rationale for engaging in collaborative action. The organization’s strategy for gaining community support should underlie the method of presenting its position; the presentation should be designed to stimulate community dialogue and result in a determination of the community’s expectations and the resulting collective position.

It is important to engage the community in this process as early as possible, although timing depends on the community’s readiness. Regardless of the situation, the organization’s capacity to analyze, establish, present, and manage positions and strategies will either facilitate or hinder the engagement process.

Building and maintaining the structural capacity to perform this work requires rigorous attention from engagement leaders. Specific insights into each capacity component for this practice element are presented in Table 4.2, which demonstrates that the structural capacity needs for this practice element are closely aligned with those of Practice Element 1.

Practice Element 3: Building and Sustaining Networks

Developing networks of collaborators is the third element in the organizational practice of community engagement. As described by Nicola and Hatcher, “developing networks is focused on establishing and maintaining relationships, communication channels, and exchange systems that promote linkages, alliances, and opportunities to leverage resources among constituent groups” (Nicola et al., 2000). In organizational practice, the development and maintenance of networks is a critical function and contributes to many organizational practice areas, specifically practices related to most of the 10 essential public health services identified by CDC 17 years ago (CDC, 1994). Effective community engagement networks should have active communication channels, fluid exchange of resources, and energetic coordination of collaborative activities among network partners. These targets can be achieved when organizations understand, support, and use available network structures. Keys to success include having the structural capacity to:

Establish, use, and monitor resource exchange systems that support network interactions and coordinated, collaborative community work.

Organizational leaders and managers must provide ongoing attention to building and maintaining the structural capacity to perform this work. The key task areas just described are dealt with more specifically in Table 4.3. The essential structural capacity needed for this practice element includes the skills and systems to communicate and relate to people on a personal basis, knowledge and understanding of community power structures, and access to communication and resource exchange networks.

Practice Element 4: Mobilizing Constituencies

The fourth and final practice element in community engagement is mobilizing constituencies, other organizations, or community members. Mobilization includes moving communities through the process of dialogue, debate, and decision making to obtain their commitment to a collaborative goal; determining who will do what and how it will be done; implementing activities; and monitoring, evaluating, adjusting, and reevaluating these activities in a cyclical fashion. Engagement leaders must be fully immersed in the building and maintaining of the structural capacity to perform this work. A key to this practice element is earning the trust required for obtaining community commitment. To this end, the engagement process must be honest, and expectations must be clear. Leaders in both the community and the engaging organization must be committed to meaningful negotiations to resolve any salient issues. Engagement efforts will flounder in the absence of transparency and reciprocity in the engagement process. Insights on the wide range of human skills, data, management structures, and material resources needed to support this practice element are found in Table 4.4.